-LRB- CNN -RRB- The measles outbreak in California is growing .

The number of cases has increased to 68 , with 48 of those cases linked to an outbreak at Disneyland , state health officials reported Friday .

Two days ago , the health department reported 59 cases , 42 with a Disney connection .

In addition , nine cases have been reported in Arizona , Utah , Washington , Colorado , Oregon and Mexico . A new case was reported in Nevada , but the Southern Nevada Health District said it 's unknown whether that case is Disney-related .

The disease outbreak apparently surfaced when visitors reported coming down with measles after visiting the park December 15-20 . At least five Disney employees have been diagnosed with measles , Disney said .

Measles is a highly communicable respiratory disease caused by a virus and spread through the air , according to the Centers for Disease Control and Prevention . Measles starts with a fever , runny nose , cough , red eyes and sore throat , the CDC said .

Dr. Gil Chavez , deputy director of the state 's Center for Infectious Diseases , recommended that children under 12 months and people who 've never had a measles vaccination stay away from the park while the disease event continues .

He made the same recommendation for other places where large numbers of people congregate , such as airports and shopping malls .

However , Chavez said Disneyland would be `` perfectly safe '' if you 've been immunized .

Opinion : Heed the lesson from Disneyland measles outbreak

When asked for a comment , Suzi Brown of Disney media relations said , `` We agree with Dr. Chavez 's comments that it is safe to visit Disneyland if you have been vaccinated . ''

For the most part , measles spreads among those who have not been vaccinated against the virus .

The California Department of Public Health said Orange County had the most measles cases with 21 , followed by San Diego County with 13 .

5 things to know about measles

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Number of measles cases in California has grown to 68 , public health officials say

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48 of those cases have been linked to California Disneyland , they said